Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction

Yamamoto, Shota; McWilliams, J.; Arellano, Cesar; Marfori, Wanda; Cheng, W.; McNamara, Tom; Quiñones-Baldrich, William J.; Ruehm, Stefan G.

doi:10.1016/j.crad.2009.07.009

Cited by 30 publications

(19 citation statements)

References 20 publications

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“…However, the use of this technique appears to be difficult for small-sized arteries. Dualenergy-based bone removal and calcium removal techniques have been used for lower extremity CTA, but thus far, no study has demonstrated any advantage of dual-energy CTA for peripheral artery applications (79)(80)(81)(82)(83)(84). An increase of the radiation dose, noise and sub-centimeter diameter of the distal peripheral arteries are limitations for dual-energy peripheral CT angiography that may be solved by high-resolution dual-energy acquisitions combined with iterative reconstruction and spectral filtering.…”

Section: Vascular Applicationsmentioning

confidence: 99%

Dual-energy CT revisited by multidetector ct: review of principles and clinical applications

Karçaaltıncaba

Aktaş²

2010

Diagn Interv Radiol

153

127

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A lthough dual-energy CT (DECT) was first conceived in 1976, it has not been used widely for clinical indications (1-11). Recently, the simultaneous acquisition of dual-energy data has been introduced using multidetector CT (MDCT) with two X-ray tubes and rapid peak kilovoltage (kVp) switching (gemstone spectral imaging, GSI) (12-16). Two major advantages of DECT are material decomposition by the almost simultaneous acquisition of two image series with different kVp (80 and 140 kVp) and the elimination of misregistration artifacts. In general, noncontrast (unenhanced) images can be avoided by using the dual-energy mode for body and neurological applications; iodine can be removed from the image, and a virtual non-contrast (water) image can be acquired. The major advantage of 80-kVp compared to 140-kVp images is a higher image contrast (Fig. 1). Hounsfield unit measurements on DECT are not absolute and can change depending on the kVp used for the acquisition (at different keV). Typically, a combination of 80/140 kVp is used for DECT, but for some applications, 100/140 kVp is preferred. In this study, we summarized the clinical applications of DECT in the brain, chest and abdomen and in the cardiovascular and musculoskeletal systems (Table 1). Technique and principlesThe basic principle of dual-energy is the acquisition of 2 datasets from the same anatomic location with different kVp (usually 80 and 140 kVp) (1,2,17,18). In the early days of CT, consecutive single-slice acquisitions with different kVp were performed as a dual-energy technique, but this method suffered from breathing and partial volume artifacts (1, 2). At present, an entire body can be scanned within seconds using the DECT technique, and thus, misregistration artifacts due to breathing are eliminated.Currently, three systems are capable of the nearly simultaneous acquisition of dual-energy data during a single breath hold (12, 14, 15): 64-slice dual-source CT (Definition, Siemens Medical Systems; Erlangen, Germany), 128-slice dual-source CT (Definition Flash, Siemens Medical Systems) and high-definition 64-MDCT (Discovery 750 HD, GE Healthcare; Milwaukee, Wisconsin, USA). In the two systems available from Siemens, the two tubes (tubes A and B) use different kVp (80 and 140 kVp), and in 64-MDCT, the kVp switches from 80 to 140 kVp in less than 0.5 ms. In dual systems, there is concern regarding the susceptibility of the system to cardiac motion due to the time difference (75 or 83 ms) between the tube A and tube B acquisitions of the dual-energy data, but the dual-source CT and 64-MDCT have not been compared to evaluate this issue. The technical specifications of the DECT systems are summarized in Table 2.The images presented in this article were acquired using a 64-slice dual source CT (Definition, Siemens Medical Systems) and a 64-MDCT (Discovery 750HD, GE Healthcare). The DECT data acquired by both systems can be evaluated with a dedicated workstation using dual-energy software that ABSTRACT Although dual-energy CT (DECT) was first conceived in ...

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Section: Vascular Applicationsmentioning

confidence: 99%

Dual-energy CT revisited by multidetector ct: review of principles and clinical applications

Karçaaltıncaba

Aktaş²

2010

Diagn Interv Radiol

153

127

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“…Its usefulness in the examination of the peripheral arteries [41][42][43][44] and the carotid and intracranial arteries [45][46][47][48][49][50] has already been reported. At this time, the dual-energy subtraction method has not yet been applied to the coronary arteries.…”

Section: Future Prospectsmentioning

confidence: 97%

Subtraction Coronary CT Angiography for the Evaluation of Severely Calcified Lesions Using a 320-Detector Row Scanner

Yoshioka

Tanaka

2011

Curr Cardiovasc Imaging Rep

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One of the major challenges in coronary computed tomography (CT) is the presence of severe calcification, which may interfere with the assessment of lesions and may reduce diagnostic accuracy. However, such calcifications may potentially be eliminated by subtracting precontrast CT image data from contrast-enhanced coronary CT angiography data. Such examinations require perfect alignment and can be performed in two ways: 1) the "single breath-hold method," in which both precontrast and postcontrast CT data are acquired during a breath-hold, and 2) the "two breath-hold method," in which the calcium scoring data are used as the precontrast CT data. Misregistration artifacts must be corrected manually based on visual assessment, which results in long image processing times. Although a number of challenges remain to be overcome, subtraction coronary CT angiography might improve the diagnostic accuracy of coronary CT angiography in patients with severe calcification in the future.

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“…Therefore, MDCTA has limited value in the evaluation of extensively calcified (especially crural) arteries [7] and conventional bone removal needs time-consuming postprocessing [13]. Dual-energy computed tomography angiography (DE-CTA) allows to remove bones and intraluminal plaques from angiographic datasets on the basis of spectral differentiation separating iodine from calcium, ideally generating a true CTA-luminogram [13][14][15][16][17][18]. Accurate and time-effective assessment of even sclerotic lesions in PAOD by consultation of three-dimensionally (3D) reconstructed images would make CT angiography more comparable to MRA and DSA and increase its acceptance in daily routine.…”

Section: Introductionmentioning

confidence: 99%

“…However, a major drawback of MDCTA is its inability to reliably discriminate between attenuation caused by high intravasal iodine concentration and attenuation caused by calcium. Therefore, MDCTA has limited value in the evaluation of extensively calcified (especially crural) arteries [7] and conventional bone removal needs time-consuming postprocessing [13]. Dual-energy computed tomography angiography (DE-CTA) allows to remove bones and intraluminal plaques from angiographic datasets on the basis of spectral differentiation separating iodine from calcium, ideally generating a true CTA-luminogram [13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Dual-energy CT angiography in peripheral arterial occlusive disease—accuracy of maximum intensity projections in clinical routine and subgroup analysis

et al. 2011

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Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction

Cited by 30 publications

References 20 publications

Dual-energy CT revisited by multidetector ct: review of principles and clinical applications

Dual-energy CT revisited by multidetector ct: review of principles and clinical applications

Subtraction Coronary CT Angiography for the Evaluation of Severely Calcified Lesions Using a 320-Detector Row Scanner

Dual-energy CT angiography in peripheral arterial occlusive disease—accuracy of maximum intensity projections in clinical routine and subgroup analysis

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